What is the ER really like?

athomas91 · Apr 7, 2004

if you think you were run like a dog on the floor - prepare yourself- the ER is (usually) no better - and you will have nastier patients on average - and nastier family members - and day shift will still complain no matter what you do....

although - i wouldn't have ever done anything else.

veetach · Apr 7, 2004

I have been where you are now. Believe me, the ER is better.

I do not work at a level 1 trauma center, so I will let those who do advise you accordingly. However, I work in a very busy 25 bed Ed, we currently see 50,000+ patients per year a do not have a fast track. We obviously see a lot of stuff that should be handled in a doctors office or just by using common sense, but that goes with the territory. We also see a lot of sick people who need to be in the Ed. We see a LOT of cardiac problems, many many MI's and then you have your average pulmonary edema, CHF and COPD'ers. Our closest Level 1 is 60 mi away, (26 min air time) so we end up recieving traumas, GSW's, stabbings, etc and stabilizing and preparing to transport.

It is never a dull moment, we have a University in our back yard so we get our share of drunk 19 yrs olds, heroin overdoses, other drug overdoses and attempted suicides...

I would recommend the ER to you, dive on in and enjoy yourself, I wish you luck!

bellehill, RN · Apr 7, 2004

I have no problem with a busy shift and actually prefer to be busy...my main job right now is convincing 5 family members they don't need to stay overnight and pushing pain meds q2-3 hours on our surgeries. If it took a genius to push Dilaudid I would be there. I am used to "PR" patients and the type that are nauseous and what Phenergan while asking what is for dinner. I am tired of being considered a waitress or personal maid. I want to use my brain again!

RNin92 · Apr 7, 2004

I worked for 8 years on a critical care floor at 2 different hospitals. Both Level II Trauma Centers before I came to the ED...4 years ago.

I loved critical care and thought that I would never leave it. But somewhere along the way the bean counters took over and things changed. People changed. Practice changed. All of sudden it didn't matter what experience a nurse had...if you had a license and a pulse you were hired.

A friend had been trying to get me to transfer to the ED forever...so I cross trained with disillusionment in my heart. It was the best decision I ever made. After 3 months I transfered and never looked back.

You will not find a better team than in the ED...they have to be that way. Everybody counts on everybody else like breathing. When we have a critical patient come in...I rarely have to ask for anything...people are just there. Don't get me wrong...there can be attitudes and in-fighting just like anywhere else...but you'll never know it in a code.

My friend that brought me down and I have a saying...almost a mantra after a particularly hard shift..."the WORST day in the ED is still better than our BEST day on the floor!" And it still is.

Climb aboard and good luck!

Stitchie · Apr 10, 2004

I honestly have to agree with the above post. I might even adopt the saying "a bad day in the ED is better than the best floor day". I worked respiratory/GMF for 6 months and just hated it.

I made the switch to ED 2 months ago and am so grateful I was able to. I had to leave the facility and company I worked for thru school and came to a totally different environment. It's so much better. The teamwork is great. yes, I do see infighting and I still get frustrated because the techs STILL don't work the same way I worked while in school, but I get to make a difference immediatly in people's lives and the impact of nursing in the ED is more than you'll believe.

Nurses work much more autonomously than on the floor and that suits me just fine. I do run my butt off and I never know what I'm going to get. Today I had a patient who could have gone to her PCP's office, a hypoglycemic and a hip pain, but I also helped another nurse with a patient who was found unresponsive at home. When the paramedics got there, they reported that the patient was foaming at the mouth. When he got to the hospital, he was confused, combative, inappropriate, and had the petechial rash all over this right side, right upper back and right arm. He was also c/o neck pain. His bp was really elevated but different in both arms! you'd think, ok, bacterial meningitis (scary, no one was masked for this guy) or aortic dissection, or huge bleed. Or maybe septic dissection.

None of the above. Did an LP -- it took 6 people to do the LP because we had to intubate / snow him in order to treat him, did ABG's, CT's, echo, EKG, had infectious disease on the case, cardiology, pulmonologist, etc. The only thing they ruled out was bacterial meningitis.

One of the docs said "Finally you guys have something interesting down here!"

So my long tale just goes to show you that you never know. You will work to the upper reaches of your skills, and then they'll get made better. That's what I love about the ED. I am constantly learning!!

I say go for it.

MrsWampthang, BSN, RN · Apr 10, 2004

If you don't mind going from one extreme to the other literally in the blink of an eye then go for it! Today we had everything from a frequent flyer with leg pain to a 9 year old in a coma from a head injury that we flew out.

A week ago was a day that will no doubt live in the history of our ER as the worst day ever; we had two trauma codes from one MVA, a second multi-vehicle accident with numerous casualties, a critical head injury from a fall that was flown out, and while the helicopter was circling to land, a medic unit came in with a critical overdose. This was all in the space of about an hour. Our ER is a level 2 trauma center, we have 16 beds and no fast track so you can imagine what chaos it was that day. Luckily it was my day off so I just heard about it second hand. I've had bad days but never that bad.

I guess my point is, in ER there is never a dull moment. You get your share of idiots, hateful family members, demanding patients, and people that don't need to be there, but you also get it balanced by the family member that gives you a big hug and thanks you for taking care of their family so well, the cute little girl that gives you a smile and a thank you after you have had to be a bad guy and give her a shot, the excitement of seeing a rapid heart rate convert right before your eyes with a little adenocard.

Nothing compares with the ER so go for it! Enjoy!

Pam

NancyBug · Apr 10, 2004

After 3 years of floor nursing in almost every specialty I am trying to find a new direction. I need some info on what working in the ER is really like, is it all people who lack common sense or do you get sick people every now and then? The hospital I will be working at is a large level 1 trauma center.
My reason for leaving floor nursing is that I am tired of being run like a dog and having day shift nit-pick everything I did while "caring" for 7 busy patients(very busy neuro-surgery/neuro floor). Am I crazy to think the ER will be better?

ER nursing is challenging and a great place to understand what teamwork means. However, I can assure you after working 12 years in a Trauma Center, you should NOT choose the ER as a place to rest. ..........

And NO, the ER is not a place for patients who lack common sense-especially at a Trauma Center. Yes, you do get the patients who have a complaint that is not emergent, the ER "regulars" and many nonemergent patients but this is a CRITICAL area for nurses who are skilled and knowledgable.

If you transfer, expect to work just as hard as there is a sign outside the door that says "Emergency" and expect patients to walk through that door 24/7with their concept of what an emergency is-what is simple to you may be truly what non healthcare people consider an emergency. Triage requires that you respect and understand this.

AND expect to see the very worst and the very best of patients, the simple and the very, very ill and also the dying.

angel337, MSN, RN · Apr 10, 2004

After 3 years of floor nursing in almost every specialty I am trying to find a new direction. I need some info on what working in the ER is really like, is it all people who lack common sense or do you get sick people every now and then? The hospital I will be working at is a large level 1 trauma center.
My reason for leaving floor nursing is that I am tired of being run like a dog and having day shift nit-pick everything I did while "caring" for 7 busy patients(very busy neuro-surgery/neuro floor). Am I crazy to think the ER will be better?

ER ROCKS!!! i have been in a level II that's more like a level I for 4 years and yes you do run your butt off, but it is SOOOOOOO different from floor nursing. i go home tired sometimes but i look forward to going to work because you learn so much and you really learn what TEAM work means. i find that ER docs are the most approachable docs you can work with and they don't mind teaching. i say go for it. you will not regret it. your floor nursing exp. will definitely benefit you because now you have experience with prioritizing. good luck!!

Sayow · Apr 15, 2004

I can say that the ER rewards far outweigh anything that I have experienced working either the floor or the ICU. You have to tap into every area of your nursing knowledge base, practically every shift. From pediatrics to gerontology, orthopedics to medicine, trauma to cardiac care, meanwhile dealing with the general public from their most vulnerable to their most volatile moments. You never know what is going to roll through the doors. For some of us that's what keeps us going back, for others there isn't enough structure to promote a comfortable environment. They usually leave, or stay and are miserable. Don't expect to get a break from the "run off your feet days" by going there. I'd actually advise a good pair of leather runners/walking shoes (avoid mesh or perforated toed shoes as they allow body fluids to come in contact with your feet) and be prepared to be on them for 12 hours. Good luck.

TinyNurse, RN · Apr 16, 2004

I've never worked anywhere but the ER, but I can say that the ER is hard, rewarding, and fun........ and all of those things combined is what makes me love it!!! The teamwork at the level II trauma center is awesome. I don't wanna sound stupid, but I actually enjoy going to work!!!

duckboy20 · Apr 16, 2004

I love the ER, if I were not back in school that is where I would probably have worked there till my feet fell off. It is a totally different feel than anywhere and you get to see a lot of cool stuff, sometimes. It does get annoying with frequent flyers and those who cannot wait 30 more minutes till the physician offices open up. You will really really learn to hate Medicare because it gets abused so much in the ER. And guess what, you are paying for that stupid person to be there! No bitterness on my part!!